A number of surgical procedures require instruments that are capable of applying a surgical fastener to tissue in order to form tissue connections or to secure objects to tissue. For example, during hernia repair it is often desirable to fasten a surgical mesh to the underlying body tissue. In laparoscopic procedures, such as for hernia repair, surgery is performed in the abdomen through a small incision, while in endoscopic procedures surgery is performed through narrow endoscopic tubes inserted through small incisions in the body. Laparoscopic and endoscopic procedures generally require long and narrow instruments capable of reaching deep within the body and configured to form a seal with the incision or tube through which they are inserted.
Currently, endoscopic techniques for hernia repair utilize fasteners, such as surgical staples or clips, to secure the mesh to the tissue thereby providing reinforcement of the repair and providing structure for the encouragement of tissue ingrowth. Another type of fastener suited for use in affixing mesh to tissue, during procedures such as hernia repair, is a coil fastener having a helically coiled body portion terminating in a tissue penetrating tip, in which the helical fastener is screwed into the mesh and body tissue. An example of this type of fastener is disclosed in U.S. Pat. No. 5,258,000 to Gianturco, assigned to Cook, Inc.
US Patent Application 20060129154 to John Shipp describes a trigger-operated mechanical tacker. Shipp uses another type of tack or screw-thread anchor that is screwed into the tissue. Shipp describes an anchor deliver device that has a handle, an actuator engaged with a rotator, an anchor retainer, an anchor advancer, a force reactor, and an anchor ejector for ejecting the anchors from the device. However, Shipp does not have a joint in the device, that is, the device has a long shaft with no bending or pivoting in the shaft. This is a disadvantage when trying to reach areas with difficult access thereto.
US Patent Application 20060047306 to Ortiz et al., assigned to Ethicon, describes a device for screwing in tacks to tissues and which has a joint in its elongate shaft. The device is not mechanical but electrically operated and uses an electroactive polymer actuator (EAP), which acts like an artificial muscle to pull or push things. In the Ethicon device, the EAP is coupled to a fastener advancing assembly such that energy delivery to the EAP causes movement of the fastener advancing assembly to advance a plurality of clips through the elongate shaft. The EAP is coupled to an articulation joint in the shaft and is adapted to move an end effector about the articulation joint relative to the elongate shaft when energy is delivered to the EAP.